Topical Immunomodulators

Prior authorization for Topical Immunomodulators has been implemented to reinforce appropriate use
and to ensure utilization consistent with approved indications. Requests for prior authorization of
Topical Immunomodulators can be initiated by either prescribers or their authorized agents. An authorized agent is an employee of the prescribing practitioner and has access to the patient's medical records (i.e. nurse, medical assistant).

Prior authorization requirements:

Prescribers are required to respond to a series of questions that identify the prescriber, the patient and the reason for prescribing this drug.